1 or both carotid arteries (CAs) protrude medially into retropharyngeal space (RPS)
IMAGING
General Features
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Al Hail AN et al: Internal carotid artery anomaly in oropharynx as a rare cause of sore throat. Aging Male. 1-4, 2020
Garrido MB et al: Retropharyngeal internal carotid artery: a review of three cases. Oral Maxillofac Surg. 24(2):255-61, 2020
Gerasymchuck M et al: Infrahyoid wandering carotid arteries. Radiol Case Rep. 15(4):400-4, 2020
Parhar HS et al: Retropharyngeal internal carotid artery management in TORS using microvascular reconstruction. Laryngoscope. 131(3):E821-7, 2020
Kim ST et al: Association between carotid artery tortuosity and carotid dissection: a case-control study. J Neurosurg Sci. 62(4):413-7, 2018
Gill JK et al: Clinically significant anatomical variation of the retropharyngeal internal carotid arteries. Radiol Case Rep. 12(3):514-8, 2017
Lukins DE et al: The moving carotid artery: a retrospective review of the retropharyngeal carotid artery and the incidence of positional changes on serial studies. AJNR Am J Neuroradiol. 37(2):336-41, 2016
Gupta A et al: Variability in the position of the retropharyngeal internal carotid artery. Laryngoscope. 123(2):401-3, 2013
Ekici F et al: Course anomalies of extracranial internal carotid artery and their relationship with pharyngeal wall: an evaluation with multislice CT. Surg Radiol Anat. 34(7):625-31, 2012
Jun BC et al: Risk factors for decreased distance between internal carotid artery and pharyngeal wall. Auris Nasus Larynx. 39(6):615-9, 2012
Marcucci C et al: Retropharyngeal carotid artery: an important anatomic variation for the anesthesiologist. Anesthesiology. 111(2):454-5, 2009
Pfeiffer J et al: A clinical classification system for aberrant internal carotid arteries. Laryngoscope. 118(11):1931-6, 2008
Ozgur Z et al: A study of the course of the internal carotid artery in the parapharyngeal space and its clinical importance. Eur Arch Otorhinolaryngol. 264(12):1483-9, 2007
Ballotta E et al: Surgical vs medical treatment for isolated internal carotid artery elongation with coiling or kinking in symptomatic patients: a prospective randomized clinical study. J Vasc Surg. 42(5):838-46; discussion 846, 2005
Coscarón Blanco E et al: [Internal carotid artery loop: an uncommon cause of parapharyngeal tumor.] An Otorrinolaringol Ibero Am. 32(2):107-13, 2005
Even-Or E et al: Medial displacement of the internal carotid arteries in velocardiofacial syndrome. Isr Med Assoc J. 7(11):749-50, 2005
Palacios E et al: Anomalous course of the carotid arteries in the retropharyngeal space poses a surgical risk. Ear Nose Throat J. 84(6):336-7, 2005
Togay-Işikay C et al: Carotid artery tortuosity, kinking, coiling: stroke risk factor, marker, or curiosity? Acta Neurol Belg. 105(2):68-72, 2005
Lai JP et al: Vascular abnormalities in the head and neck area in velocardiofacial syndrome. Chang Gung Med J. 27(8):586-93, 2004
Galletti B et al: Internal carotid artery transposition as risk factor in pharyngeal surgery. Laryngoscope. 112(10):1845-8, 2002
Paulsen F et al: Curving and looping of the internal carotid artery in relation to the pharynx: frequency, embryology and clinical implications. J Anat. 197 Pt 3:373-81, 2000
Vega J et al: Internal carotid artery transposition: another cause of widening of the retropharyngeal space. Eur Radiol. 9(2):347-8, 1999
Schumacher WA et al: [Variations in the course of the internal carotid artery: possible risks in so-called standard operations in the area of the pharynx.] Laryngorhinootologie. 77(9):517-20, 1998
Jäckel M: [Anatomic variants of the internal carotid artery as differential parapharyngeal space-occupying lesions diagnosis.] HNO. 45(12):1018-21, 1997
Fix TJ et al: Carotid transposition: another cause of wide retropharyngeal soft tissues. AJR Am J Roentgenol. 167(5):1305-7, 1996
Poulias GE et al: Kinking and coiling of internal carotid artery with and without associated stenosis. Surgical considerations and long-term follow-up. Panminerva Med. 38(1):22-7, 1996
Schenk P et al: [Current aspects in diagnosis and therapy of carotid artery kinking.] HNO. 44(4):178-85, 1996
Deutsch MD et al: Distance between the tonsillar fossa and internal carotid artery in children. Arch Otolaryngol Head Neck Surg. 121(12):1410-2, 1995
Tillmann B et al: [The "dangerous loop" of the internal carotid artery. An anatomic study.] HNO. 43(10):601-4, 1995
Davis WL et al: The normal and diseased infrahyoid retropharyngeal, danger, and prevertebral spaces. Semin Ultrasound CT MR. 12(3):241-56, 1991
Lukovskii RV et al: [Abnormal location of a large artery in the posterior wall of the pharynx.] Vestn Otorinolaringol. (4):59, 1991
Hendrix RA et al: Localization of the carotid artery within the tonsillar fossa by Doppler flow mapping. Laryngoscope. 100(8):853-6, 1990
MacKenzie-Stepner K et al: Abnormal carotid arteries in the velocardiofacial syndrome: a report of three cases. Plast Reconstr Surg. 80(3):347-51, 1987
1 or both carotid arteries (CAs) protrude medially into retropharyngeal space (RPS)
IMAGING
General Features
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Al Hail AN et al: Internal carotid artery anomaly in oropharynx as a rare cause of sore throat. Aging Male. 1-4, 2020
Garrido MB et al: Retropharyngeal internal carotid artery: a review of three cases. Oral Maxillofac Surg. 24(2):255-61, 2020
Gerasymchuck M et al: Infrahyoid wandering carotid arteries. Radiol Case Rep. 15(4):400-4, 2020
Parhar HS et al: Retropharyngeal internal carotid artery management in TORS using microvascular reconstruction. Laryngoscope. 131(3):E821-7, 2020
Kim ST et al: Association between carotid artery tortuosity and carotid dissection: a case-control study. J Neurosurg Sci. 62(4):413-7, 2018
Gill JK et al: Clinically significant anatomical variation of the retropharyngeal internal carotid arteries. Radiol Case Rep. 12(3):514-8, 2017
Lukins DE et al: The moving carotid artery: a retrospective review of the retropharyngeal carotid artery and the incidence of positional changes on serial studies. AJNR Am J Neuroradiol. 37(2):336-41, 2016
Gupta A et al: Variability in the position of the retropharyngeal internal carotid artery. Laryngoscope. 123(2):401-3, 2013
Ekici F et al: Course anomalies of extracranial internal carotid artery and their relationship with pharyngeal wall: an evaluation with multislice CT. Surg Radiol Anat. 34(7):625-31, 2012
Jun BC et al: Risk factors for decreased distance between internal carotid artery and pharyngeal wall. Auris Nasus Larynx. 39(6):615-9, 2012
Marcucci C et al: Retropharyngeal carotid artery: an important anatomic variation for the anesthesiologist. Anesthesiology. 111(2):454-5, 2009
Pfeiffer J et al: A clinical classification system for aberrant internal carotid arteries. Laryngoscope. 118(11):1931-6, 2008
Ozgur Z et al: A study of the course of the internal carotid artery in the parapharyngeal space and its clinical importance. Eur Arch Otorhinolaryngol. 264(12):1483-9, 2007
Ballotta E et al: Surgical vs medical treatment for isolated internal carotid artery elongation with coiling or kinking in symptomatic patients: a prospective randomized clinical study. J Vasc Surg. 42(5):838-46; discussion 846, 2005
Coscarón Blanco E et al: [Internal carotid artery loop: an uncommon cause of parapharyngeal tumor.] An Otorrinolaringol Ibero Am. 32(2):107-13, 2005
Even-Or E et al: Medial displacement of the internal carotid arteries in velocardiofacial syndrome. Isr Med Assoc J. 7(11):749-50, 2005
Palacios E et al: Anomalous course of the carotid arteries in the retropharyngeal space poses a surgical risk. Ear Nose Throat J. 84(6):336-7, 2005
Togay-Işikay C et al: Carotid artery tortuosity, kinking, coiling: stroke risk factor, marker, or curiosity? Acta Neurol Belg. 105(2):68-72, 2005
Lai JP et al: Vascular abnormalities in the head and neck area in velocardiofacial syndrome. Chang Gung Med J. 27(8):586-93, 2004
Galletti B et al: Internal carotid artery transposition as risk factor in pharyngeal surgery. Laryngoscope. 112(10):1845-8, 2002
Paulsen F et al: Curving and looping of the internal carotid artery in relation to the pharynx: frequency, embryology and clinical implications. J Anat. 197 Pt 3:373-81, 2000
Vega J et al: Internal carotid artery transposition: another cause of widening of the retropharyngeal space. Eur Radiol. 9(2):347-8, 1999
Schumacher WA et al: [Variations in the course of the internal carotid artery: possible risks in so-called standard operations in the area of the pharynx.] Laryngorhinootologie. 77(9):517-20, 1998
Jäckel M: [Anatomic variants of the internal carotid artery as differential parapharyngeal space-occupying lesions diagnosis.] HNO. 45(12):1018-21, 1997
Fix TJ et al: Carotid transposition: another cause of wide retropharyngeal soft tissues. AJR Am J Roentgenol. 167(5):1305-7, 1996
Poulias GE et al: Kinking and coiling of internal carotid artery with and without associated stenosis. Surgical considerations and long-term follow-up. Panminerva Med. 38(1):22-7, 1996
Schenk P et al: [Current aspects in diagnosis and therapy of carotid artery kinking.] HNO. 44(4):178-85, 1996
Deutsch MD et al: Distance between the tonsillar fossa and internal carotid artery in children. Arch Otolaryngol Head Neck Surg. 121(12):1410-2, 1995
Tillmann B et al: [The "dangerous loop" of the internal carotid artery. An anatomic study.] HNO. 43(10):601-4, 1995
Davis WL et al: The normal and diseased infrahyoid retropharyngeal, danger, and prevertebral spaces. Semin Ultrasound CT MR. 12(3):241-56, 1991
Lukovskii RV et al: [Abnormal location of a large artery in the posterior wall of the pharynx.] Vestn Otorinolaringol. (4):59, 1991
Hendrix RA et al: Localization of the carotid artery within the tonsillar fossa by Doppler flow mapping. Laryngoscope. 100(8):853-6, 1990
MacKenzie-Stepner K et al: Abnormal carotid arteries in the velocardiofacial syndrome: a report of three cases. Plast Reconstr Surg. 80(3):347-51, 1987
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